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WORLD GASTROENTEROLOGY NEWS JANUARY 2015
Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events
Lutz (USA), a member of the execu-tive
committee of the FIP community
pharmacy section (CPS), who further
discussed the “impact of guidelines in
pharmacy practice,” emphasizing the
role of community pharmacists in the
treatment of common GI symptoms.
The application of daily pharmacy
practice was presented by Paul Sinclair
(CPS, Australia) using a couple of case
studies.
Reflux and heartburn as a self-care
model was another topic of discussion
as a part of an industry sponsored
satellite symposium on self-care in
the 21st century. Different issues of
self-care were discussed by experts
in the field, including the role of
pharmacists, a health care economic
perspective, with reflux/ heartburn
used as a self-care model. In dealing
with heartburn, which is the hallmark
of gastroesophageal reflux disease
(GERD), it is important to recognize
the alarm symptoms which should
prompt further investigations. Treat-ment
includes lifestyle modification
and acid reducing agents. The use of
prokinetic agents has been limited by
their unproven efficacy and side ef-fects.
As far as self-care is concerned in
heartburn/GERD, the relief of symp-toms
is the main goal. In the pres-ence
of alarm features, self-treatment
should be avoided and patients should
be referred to GI specialists for further
investigation.
There is increasing public interest
in self-medication for common GI
symptoms with OTC medications
which have become readily available.
The WGO Global Guideline was de-veloped
with a joint effort among GI
specialists, primary care experts, and
FIP representatives to guide in the
management of common GI symp-toms,
including: heartburn, abdomi-nal
pain/ discomfort, bloating and
constipation. The guideline provides
diagnostic and treatment cascades,
with resource-sensitive recommenda-tions
mainly focusing on self-care
to the role of pharmacists in the
utilization of the OTC medications.
Pharmacists could serve as frontline
healthcare professionals in self-care,
recognizing problems and providing
consultations related to therapy (such
as drug side-effects, drug interactions,
and timely referrals to primary care
providers or GI specialists). The main
concerns of the self-care approach
using OTC medications are the possi-bilities
of misdiagnosis or under-treat-ment
of the underlying conditions,
although it is unlikely as they are of
mild severity. It is important to iden-tify
patients with a high likelihood of
a serious condition in the presence of
alarm features and failed therapy so
that they can be referred for proper
investigation and management.